Individual
MARY BRONWYN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3205 RANDALL PKWY, SUITE 105, WILMINGTON, NC 28403-2564
(910) 742-9243
(888) 746-1787
Mailing address
PO BOX 538622, ATLANTA, GA 30353-8622
(910) 742-9243
(888) 746-1787
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2864
NC
103TC0700X
Clinical Psychologist
2864
NC
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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